IMH Admitting Rep, Full Time- Evenings

About the role

Join Ingalls Memorial Hospital as an Admitting Representative at our Harvey, IL location. This department is known for its dedication to customer service and ensuring each patient has a positive experience.

Responsibilities

• Promptly fields and/or directs incoming calls, responds to patient and/or staff inquiries with resolution or escalation
• Ensures all registration and admission forms are presented to and verified by patient/guarantor before signing; Ensuring patients/guarantor understand what is being signed
• Practices proficient customer-service skills by greeting and treating all patients and staff with respect and discretion
• Gathers and verifies all appropriate, confidential health and financial information from patients while using various computer software to assure payment for all authorized services
• Enters new patient data and/or verifies patient records are up-to-date, confirms the completeness of the electronic health record (EHR), makes changes as necessary, and files records in accordance with Ingalls Memorial hospital’s filing system
• Complies with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPPA)
• Verifies insurance eligibility and benefits immediately for non-emergent cases and no later than end of shift for emergent cases, and obtains pre-authorizations from third-party payers in accordance with payer requirements
• Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient
• Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EDM
• Holds sufficient understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzes information received to determine patients’ out-of-pocket liabilities
• Understands the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
• Engages with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
• Scans all documents in the appropriate document type in the hospital system
• Engages in direct patient contact with our patients and/or their family members and must have the ability to multi-task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
• Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
• Identifies via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission